Permission Form — Brain Balance | Mindfulness & Psychoeducation

Your Name prefix, Mr or Mrs?

Peaceful Kids & Chair Yoga Program - Parental Permission Form

Your Full Name

Your E-mail

Phone

Your Child's Full Name

Your Child's Age

Does your child have any medical conditions or special needs that we should be aware of? If so, please indicate below:

TERMS & CONDITIONS

1. The Peaceful Kids & Chair Yoga program is an educational Mindfulness & Positive Psychology program for children. It is not a counselling or therapeutic program.

2. Occasionally children are not suitable for this group workshop which can be due to several reasons including the group dynamics. If your child is struggling to manage the group environment with other children, you will be contacted to discuss alternative options for your child. If your child is not being respectful to other children or very disruptive, all efforts will be made to keep your child in the group, however at times children may be asked to leave the group and this will be discussed with you to manage the best way forward.

3. Child's Absence (applies to classes conducted in private preschools only). We understand that unforeseen circumstances may arise, and we want to assure you that we are dedicated to ensuring a seamless learning experience for each child in our small class groups of 4-6 children. In the even that just one child is present, the class will be automatically rescheduled for the following week, and you will be promptly notified of any such situations. While individual replacement classes are not offered for group courses, alternative options exist to prevent your child from missing out:

Option A: Attending a Different Class: Should your child miss a session, they have the option to attend the same class at a different location in Wrocław, provided the same topic is being covered currently.

Option B: In the case of two absentees, a replacement class will be scheduled at a mutually convenient time.

Option C: While our aim is for each child to attend all sessions, unforeseen circumstances may arise. In such situations, we will offer a partial refund (45 PLN gross per missed class) to the initial payment account.

4. In an effort to enhance our classroom experience and share the joy of your child's learning journey with our wider community, we seek your consent for the occasional use of filming and photography during class lessons. Your child's participation is entirely voluntary, and we want to ensure that you are comfortable with this practice. Any footage or images captured will be used solely for educational and promotional purposes related to Brain Balance Mindfulness & Psychoeducation Centre, including sharing on social media.

Consent

Partial Consent (faces obscured)

No Consent

By signing below, I acknowledge that I have read and understood the terms and conditions of my child's participation in the Peaceful Kids educational program, and I consent to their involvement.

Consent

Thank you for your cooperation in creating a positive and enriching learning environment for all our students.

Date